DISCLOSURE FORM OPTIONAL CREDIT INSURANCE
Credit life insurance and credit health insurance provide protection for both the buyer and seller.
You are entitled to a copy of the policy or certificate of insurance within thirty days after credit is extended.
You ARE NOT required to buy credit life insurance or credit health insurance from any particular insurance company or agent. You may use existing policies if insurance is required as additional security.
If you buy credit life insurance, the proceeds will be used to reduce or pay off your unpaid loan or indebtedness when you die. Any insurance proceeds in excess of the amount required to pay off the loan will be paid to your beneficiary or estate.
If you buy credit health insurance, the proceeds will be used to reduce or pay off your unpaid loan or indebtedness if you become incapacitated.
READ your policy or certificate CAREFULLY for what the policy DOES NOT cover. For example: Some policies do not cover the total loan amount or the entire period of coverage. Some policies do not pay disability benefits unless you are disabled for 14 or 30 days or if you have a preexisting condition. Some policies will not provide coverage if you are age 66 or more or when you reach 66. See the policy for details on these matters.
You may not be eligible for credit health insurance unless you now work at least thirty hours per week, unless unemployed solely due to seasonal lay-off.
By initialing below, the customer, debtor or lessee acknowledges acceptance or refusal of credit life or credit health insurance.
ACCEPTS CREDIT LIFE INSURANCE
DECLINES CREDIT LIFE INSURANCE
ACCEPTS CREDIT HEALTH INSURANCE
DECLINES CREDIT HEALTH INSURANCE
Or. Admin. Code § 836-060-0060
Stat. Auth.: ORS 731, 742, 743 & 746
Stats. Implemented: ORS 743.015, 743.376, 743.377 & 746.240